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العنوان
EARLY DETECTION OF BREAST CANCER IN WOMEN EXPOSED TO ENVIRONMENTAL ESTROGEN /
المؤلف
Hanoraa, Nihad Ahmed Mostafa .
هيئة الاعداد
باحث / Nihad Ahmed Mostafa Hanoraa
مشرف / Mahmoud Serry El Bokhary
مشرف / Omar Sherlf Omar
مناقش / Hassan Mohamed Zakria Shaker
تاريخ النشر
2018.
عدد الصفحات
212P.;
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
العلوم البيئية (متفرقات)
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - معهد البيئة - علوم طبية بيئية
الفهرس
Only 14 pages are availabe for public view

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from 212

Abstract

s digital tomosynthesis is newly introduced in Egypt; the present study was designed to evaluate the role of screening of women exposed to environmental estrogen. In addition, to determine the predictive value of mammography for early detection of breast cancer in women exposed to environmental estrogen. It included 50 women with known exposure to environmental estrogen whether at their work or at home (their environment), with or without complaint related to breast. In addition, another 50 women with known state of un-exposure to environmental estrogens were included as a control group. All females completed a pre-structured questionnaire about their demographics; exposure to environmental estrogens and possible breast complaints. Then, all females underwent to classical mammography, digital tomosynthesis and MRI on their breast to detect any breast cancers.
Results of the present stu`dy revealed the following:
• In the present study, age ranged from 45 to 63 years with a mean of 53.04±3.65; and there was non-significant difference between study and control group (52.66±4.34 vs 43.82±3.15 respectively). On the other hand, weight ranged from 59 to 78 kg with a mean of 65.72±3.70 kg and there was significant increase of weight in study group when compared to control group (67.98±3.34 vs 63.46±2.49 respectively). Similarly, there was significant increase of BMI in study group when compared to control group (25.68±1.31 vs 23.84±0.94 respectively).
• As regard residence, 56% of cases were urban and 44% were rural and there was significant increase of rural cases in study group when compared to control group (56.0% vs 32.0% respectively). In addition, there was significant increase of unmarried cases (singles) in study group when compared to control group (30.0% vs 10.0% respectively). Finally, there was significant decrease of cases with higher education in study group when compared to control group (12.0% vs 54.0% respectively). However, there was no significant difference between cases and controls as regard to employment (80.0% vs 76.0% respectively).
• As regard to pregnancy, delivery and breast feeding, there was significant decrease in study group when compared to control group (62.0%, 44.0%, 26.0% vs 90.0%, 80.0%, 62.0% respectively).
• As regard to family history, there was significant increase of positive family history in study group when compared to control group (28.0% vs 6.0% respectively).
• As regard to both age of menarche and menopause; there was no significant difference between study and control groups.
• As regard to factors of exposure or possible risk factors; there was significant increase of cosmetics, smoking exposure, physical inactivity, frequent fish consumption and decrease of frequent fruit intake in study group when compared to Control group (88.0%, 68.0%, 62.0%, 23.0%, 22.0% vs 70.0%, 14.0%, 42.0%, 8.0%, 74.0% in the same order). On the other hand, no significant difference was found between study and control groups as regard to hormone replacement therapy, hormonal contraceptive, exposure to radon or asbestos, wearing bra, type of diet or plastic use.
• As regard to frequency of complaint in study group; pain in the breast was reported in 72.0% of cases; lump in 44% of cases, nipple discharge in 26.0% of cases and breast skin changes in 22.0% of cases.
• As regard to results of classic mammography, it was positive in 25 cases (25.0%) with significant increase of positive cases in study group when compared to control group (40.0% vs 10.0% respectively).
• As regard size of lesion detected by classic mammography, it ranged from 4.1 to 8.0 mm; and there was no significant difference between study and control groups.
• As regard results of digital tomosynthesis; it revealed 29 positive cases (25 in study group; 50%) and (4 in control group; 8%). When compared to classic mammography alone, it detected more 5 positive cases in study group and decreased one in the control group.
• As regard results of MRI, it revealed 25 positive cases in study group (50.0%) and 6 positive cases in control group (12.0%) with significant difference between cases and controls
• As regard relation between classic mammography and MRI; mammogram revealed 20 positive cases; only 16 of them were positive by MRI (80.0%); thus it has false positive rate of 20%. In addition, it revealed 30 negative cases; only 21 of them were negative by MRI (70.0%); thus, it had 30.0% false negative rate.
• Calculating different measures of mammography in relation to MRI; it revealed that, mammography had a sensitivity of 80.0%; specificity of 70% and overall accuracy of 74.0%.
• As regard relation between digital tomosynthesis and MRI; DT revealed 25 positive cases; only 23 of them were positive by MRI (92.0%); thus it has false positive rate of 8.0%. In addition, it revealed 25 negative cases; only 23 of them were negative by MRI (92.0%); thus, it had 8.0% false negative rate.
• Calculating different measures of DT in relation to MRI; it revealed that, mammography had a sensitivity of 92.0%; specificity of 92.0% and overall accuracy of 92.0%.
• When comparing such results with classical mammography alone; it revealed better values for detection of both positive and negative cases (ie. Better sensitivity and specificity).
• Searching for possible risk factors for development of breast cancer in exposed group; we can identify employment, smoking and cosmetics as the most important risk factors in this group.